Takotsubo-Like Syndrome in Cancer Patients Treated With Immune Checkpoint Inhibitors

Éderhy, Stéphane; Cautela, Jennifer; Ancédy, Yann; Escudier, Marion; Thuny, Franck; Cohen, Ariel

doi:10.1016/j.jcmg.2017.11.036

Cited by 88 publications

(71 citation statements)

References 2 publications

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“…Recent reports have also highlighted the risk of cardiotoxicity related to ICI administration, including atrial fibrillation, atrioventricular block, pericardial effusion, and myocarditis . We have recently described cases of takotsubo‐like syndrome occurring in patients receiving ICIs . To identify whether this is clinically important, we performed a disproportionality analysis using the World Health Organization (WHO) global database of individual case safety reports (ICSRs) (VigiBase®), including adverse drug reaction (ADR) reports, to evaluate the reporting odds ratios (RORs) of stress cardiomyopathy (preferred term) associated with ICIs.…”

Section: Vigibase® Analysis: Characteristics Of Patients With Stress mentioning

confidence: 99%

Takotsubo syndrome in patients with cancer treated with immune checkpoint inhibitors: a new adverse cardiac complication

Éderhy

Dolladille

Thuny

et al. 2019

European J of Heart Fail

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Section: Vigibase® Analysis: Characteristics Of Patients With Stress mentioning

confidence: 99%

Takotsubo syndrome in patients with cancer treated with immune checkpoint inhibitors: a new adverse cardiac complication

Éderhy

Dolladille

Thuny

et al. 2019

European J of Heart Fail

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“…In another review of reported cases of 42 patients of ICI-associated myocarditis, 36% reported normal EF (8). Additionally, takotsubo-like syndrome as a cardiotoxicity manifestation has been reported in a couple of cases treated with combination ICIs (23).…”

Section: Presentation and Diagnosis Of Ici-associated Myocarditismentioning

confidence: 98%

“…Patients with ICI-associated myocarditis have been found to have a reduction in their LVEF, isolated RV dysfunction, or biventricular dysfunction, with a varying degree of abnormalities in regional wall abnormalities in some of these patients (7,8,10,23). The role of echocardiography in structural and functional assessment of LV and RV function in patients with myocarditis has been well established (37,38).…”

Section: Structural and Functional Analysismentioning

confidence: 99%

Clinical and Advanced MRI Techniques for Detection of Checkpoint Inhibitor Associated Myocarditis

Arbune

Soufer

Baldassarre

2020

Curr Cardiovasc Imaging Rep

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Purpose of Review With the advent of immune checkpoint inhibitors (ICIs), cancer treatment has been revolutionized; however, these agents are associated with immune-related adverse events, including myocarditis, which ranges from mild to fulminant in severity. Currently, there are no established guidelines in diagnosing ICI-associated myocarditis, and the gold standard test for diagnosis of myocarditis in general is invasive endomyocardial biopsy (EMB). Cardiac magnetic resonance (CMR) imaging is a noninvasive test with the advantage of providing structural, functional and tissue characterization information. Additionally, it provides high spatial and temporal resolution without exposure to ionizing radiation, iodinated contrast, or radioactive isotopes. Recent Findings With an increasing number of reported cases of ICI associated myocarditis, understanding of the disease process and associated CMR findings is growing. Diagnostic testing with cardiac biomarkers, electrocardiogram, and echocardiogram can be nonspecific and EMB can have sampling errors. CMR as a diagnostic tool can provide functional assessment of biventricular ejection fraction, myocardial strain, tissue characterization of myocardial edema and inflammation as well as fibrosis. Furthermore, with advanced parametric mapping techniques, CMR provides even more sensitive and quantitative information about myocardial inflammation and fibrosis, including measurements of extracellular volume. Summary ICI-associated myocarditis is a serious immune adverse event, and CMR plays a vital role in establishing its diagnosis, providing prognostic information, and has the potential for use as a tool for screening and serial monitoring in patients exposed to ICIs.

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“…Typical echocardiography and left ventriculography, which are helpful in identifying the diagnosis, are systolic apical ballooning of the left ventricle, reflecting depressed mid‐ and apical segments with hyperkinesis of the basal wall. Coronary angiography will exclude severe obstructive lesions . CMR could find myocardial edema but usually without myocardial late gadolinium enhancement .…”

Section: Clinical Manifestationmentioning

confidence: 99%

Clinical manifestation and management of immune checkpoint inhibitor‐associated cardiotoxicity

et al. 2019

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Immune checkpoint inhibitors (ICIs) targeting programmed death-1 (PD-1), its ligand (PD-L1), and cytotoxic T-lymphocyte-associated antigen 4 (CTLA4) have revolutionized cancer treatment by recovering the attack of T lymphocytes on the malignant cells. They have improved clinical outcomes dramatically in multiple types of advanced-stage malignancies. Even though the tolerance and safety profiles are generally good, it has been widely reported that ICIs can cause severe or fatal immune-related adverse events (irAEs), since the activated T lymphocytes are not specific for tumor cells. Cardiac irAEs appear to occur less frequently than irAEs in other organ systems but are notorious for high mortality. Here, we aim to identify and characterize the ICI-associated cardiotoxicity and summarize the optional diagnosis and treatment strategies.

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Takotsubo-Like Syndrome in Cancer Patients Treated With Immune Checkpoint Inhibitors

Cited by 88 publications

References 2 publications

Takotsubo syndrome in patients with cancer treated with immune checkpoint inhibitors: a new adverse cardiac complication

Takotsubo syndrome in patients with cancer treated with immune checkpoint inhibitors: a new adverse cardiac complication

Clinical and Advanced MRI Techniques for Detection of Checkpoint Inhibitor Associated Myocarditis

Clinical manifestation and management of immune checkpoint inhibitor‐associated cardiotoxicity

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